President Barack Obama is applauded as he signs the healthcare reform bill, Tuesday, March 23, in the East Room of the White House in Washington.

Charles Dharapak/AP

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Washington

Healthcare reform has been signed into law. But the battle to sell it continues.

Republicans, none of whom voted for the bill, are seizing on public dissatisfaction and confusion over healthcare reform to push for repeal as a key argument in the fall elections. Democrats know they have to fight back. And so it falls on party leaders, from President Obama on down, to settle on a single, simple message and then pound it home.

“In a few moments, when I sign this bill, all of the overheated rhetoric over reform will finally confront the reality of reform,” Obama said to a crowd of Democratic lawmakers and invited guests.

Obama accentuates the positive

Among the elements the president stressed, all of which begin this year: tax credits for small businesses to help them provide insurance for employees; a ban on dropping the insurance of people who get sick; a ban on refusing insurance for children with preexisting conditions; and allowing parents to put adult children up to age 26 on their policies.

Obama also appealed to American exceptionalism in speaking to what he called “the core principle” that everybody should have access to healthcare.

“We are a nation that faces its challenges and accepts its responsibilities,” he said. “We are a nation that does what is hard, what is necessary, what is right.”

Republicans, meanwhile, are marshalling their arguments as they call for repeal.

In his “Roadmap for America’s Future,” Congressman Ryan would change the employment-based insurance system with tax credits that allow employees to purchase insurance on their own, which would de-link employment and health insurance.

GOP: 'We've got a better idea'

“Obviously we’re not for keeping this law,” Ryan told the Politico website in a videotaped interview. “We should repeal it and replace it with reform, but not just to go back to the status quo that we knew yesterday.”

For now, though, most Republicans are focused just on repeal. The Democratic challenge, in protecting what they have passed, is to convince the public that it’s a good thing – both to halt any momentum toward repeal before it starts and to help the party’s candidates in the fall midterms.

Part of what made achieving reform so difficult, despite the Democrats’ big majorities in Congress, is that Obama and other leaders kept changing the rationale for healthcare reform.

Initially, it was framed as a part of economic reform – that “bending the cost curve” on healthcare inflation would help the nation’s fiscal health. Then it became a plan to insure the uninsured, of which 32 million Americans are now projected to join the rolls in the next four years. By the end, Obama was arguing for making history and for fending off an insurance industry that would “run wild” if unchecked, continuing to deny people coverage and imposing massive rate increases.

Now that the bill has passed, Obama is on a mission to help the public understand what’s in it – especially the parts that are widely popular. The challenge will be to keep the unpopular parts – such as the cost and the prospect of greater government involvement in the healthcare system – from giving his opponents momentum.

For Obama, the good news is that he is still president at least until January 2013. If any full or partial repeal crosses his desk, he can veto it.